Corneal Ulcer management practices in the rural Nepal

Sanjay Kumar Singh

Aim:
This study was carried out to describe existing management practices for corneal ulcers in the Eastern region of Nepal.

Methods:
A qualitative study design was used to investigate existing management practices of suppurative keratitis in the Eastern region of Nepal. A non-probabilistic, purposive sampling method was used to select study participants. For the purpose of data collection different tools (structured, semi-structured interviews, focus group discussions, in-depth interviews and observations) were used. Data and methodological triangulation was done to increase trustworthiness of the study.

Results:
Many corneal ulcer patients were seeking medical and non medical help before coming to eye hospitals. In rural and urban areas majority of corneal ulcer patients were seeking advice from community service providers (traditional healers and medical shop keepers). First point of consultation in rural areas was traditional healers and medical shop keepers in urban areas. Most of corneal ulcer patients who consulted medical shop keepers, health care providers and eye care providers were managed empirically. Frequency of antibiotic eye drop instillation by medical shop keepers and health care providers was much less than recommended for a case of corneal ulcer.

Recommendations:
At present when the existing eye care services are limited to the urban areas in the Eastern region of Nepal, role of community service providers and health care providers can not be undermined for the primary management/prevention of corneal abrasion/ulcer. Existing management practices can be improved by involving all level of manpower appropriately for corneal ulcer management.